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Volume 2016, Article ID 3012802, 9 pages
Review Article

Investigation and Management of Adnexal Masses in Pregnancy

1Department of Obstetrics and Gynecology, São João Hospital Centre, 4200-319 Porto, Portugal
2Porto Medical Faculty, 4200-319 Porto, Portugal

Received 5 December 2015; Accepted 16 March 2016

Academic Editor: Shunsuke Nakagawa

Copyright © 2016 João Cavaco-Gomes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Adnexal masses can be found in 0.19 to 8.8% of all pregnancies. Most masses are functional and asymptomatic and up to 70% resolve spontaneously in the second trimester. The main predictors of persistence are the size (>5 cm) and the imagiological morphocomplexity. Those that persist carry a low risk of malignancy (0 to 10%). Most malignant masses are diagnosed at early stages and more than 50% are borderline epithelial neoplasms. Ultrasound is the preferred method to stratify the risk of complications and malignancy, allowing medical approach planning. Pregnancy and some gestational disorders may modify the levels of tumor markers, whereby their interpretation during pregnancy should be cautious. Large masses are at increased risk of torsion, rupture, and dystocia. When surgery is indicated, laparoscopy is a safe technique and should ideally be carried out in the second trimester of pregnancy.